Is Family the "Missing Piece" in Substance Use Disorder Recovery
- Carolyn Bradfield
- Oct 3
- 4 min read
October 6, 2025
Carolyn Bradfield, Author & CEO, Pathroot Health
Reviewed by Sandy Rivers, Subject Matter Expert
Substance Use Disorder (SUD) encompasses the persistent use of substances, drugs, and/or alcohol despite the substantial harm and adverse consequences to oneself, family, and friends.
Substance use disorder and family involvement significantly impact families, and support in treatment can reduce the harms and can also improve treatment entry, treatment completion, and treatment outcomes for the individual coping with a substance use disorder.
Author Carolyn Bradfield faced a devastating loss when her daughter overdosed and died in 2017. Carolyn's daughter struggled with substance use disorder (SUD) and entered an outdoor behavioral program at 15, followed by a therapeutic boarding school.
According to Carolyn Bradfield:
When my daughter Laura started her journey with substance use disorder, she was only 15 years old, and as parents, we were overwhelmed, traumatized, ashamed, and confused about how to help her. So we did what most people do: started with therapy, but moved to more aggressive rehab treatment. She looked great when she was discharged, but then quickly relapsed, despite our best attempts to help her, and ended right back in treatment. Programs offered little guidance and support, leaving us feeling like nothing we were doing was working. Ultimately, after a 15-year struggle, Laura overdosed and died, leading me to wonder if Laura's trajectory would have been different had we been better educated, informed, and guided by the programs that had Laura under their care.
One of my favorite books is The Missing Piece. Author Shel Silverstein describes a nearly complete circle that seeks a "missing piece" to complete it. This book made me think about the search for a missing piece in substance use disorder recovery to reduce those incredibly high relapse rates.
When we think about substance use disorder, we often focus on the individual: therapy, medication, and support groups. These are all essential "pieces," but what if a "missing piece" is the family? Substance use disorder recovery is often seen as an individual journey. Still, substance use disorder impacts not just the person but their entire family, who should play a critical role in recovery by offering support, understanding, and accountability. The potential benefits of family involvement in SUD recovery are numerous, including reduced relapse rates, improved treatment outcomes, and a stronger support system for the individual in recovery.
Today, families are often kept at arm's length when a loved one is in treatment. They may attend a family day and learn about substance use disorder. Still, they aren't usually significantly involved, nor do they help clarify their role in the substance use disorder recovery process. So, without realizing it, they fail to set boundaries, communicate poorly due to frustration, and make counterproductive decisions during the recovery process.
Research indicates that an informed and engaged family can significantly reduce substance use disorder relapse rates by up to 30%. Family involvement is not just about being present for your loved one; it's about actively learning how to navigate the emotional and psychological challenges that come with substance use disorder. This knowledge can be empowering and can lead to more positive outcomes.
Putting the Family at the Center of a "Circle of Care"
It takes an entire circle of care to help individuals manage the chronic disease of substance use disorder and stay in recovery. This circle could include treatment professionals, therapists, sponsors, friends, and supporters. However, since most people coming out of treatment live with a family member, here are some thoughts on how to help the family complete the circle.
Involve Families Early in the Process: Before and during substance use disorder treatment, educate and involve family members to understand addiction and recovery. Family involvement from the beginning helps set expectations and prepares them to support their loved ones and heal their family.
Provide Ongoing Education and Resources: Offer families access to resources that include substance use disorder education, coping strategies, maintaining boundaries,
and effective communication, empowering them to support their loved ones effectively.
Create Clear Communication Channels: Ensure families have regular access to progress updates, treatment plans, and open lines of communication with the treatment team. Clear communication channels build trust and ensure everyone is aligned on goals.
Encourage Active Participation in therapy by including family members in sessions, support groups, and substance use disorder recovery meetings. For instance, family members can participate in role-playing exercises during therapy sessions to gain a deeper understanding of their loved one's challenges. They can also attend support groups to learn from the experiences of other families and share their own. Active involvement helps families understand their loved one's challenges and enables them to contribute meaningfully to their healing.
Substance use disorder recovery is not a journey that ends when treatment does. It's a lifelong process. That's why it's crucial to continue supporting families through post-treatment services, such as regular check-ins, family counseling, and peer support groups. Having ongoing support is designed to ensure a lasting recovery and to maintain the family's role in the process, providing a sense of reassurance and support.
Takeaway
As Shel Silverstein writes, "When the missing piece finally arrives, the circle will be complete." In the context of substance use disorder recovery, perhaps the missing piece is the family, the people who love and care for the person in recovery and who can play an essential role in helping them heal.
The journey to substance use disorder recovery should not be walked alone. The family can be the anchor, the support system, and the motivation needed to ensure long-term success. By embracing the family's role in recovery, we can help reduce high relapse rates and build a stronger foundation for lasting recovery. Your role is not just important, it's integral to the process, making you a valued and essential part of the recovery journey.
Carolyn Bradfield earned an MBA from Georgia State University and a Bachelor of Arts in English Language and Literature from Valdosta State University. She founded Pathroot Health to provide critical services designed to help families navigate the crisis support system for families and navigate the crisis caused by substance misuse and addiction. To learn more about their services, please visit their website at www.pathroothealth.com and look for Carolyn as CEO. If you want to reach out to Carolyn, her email address is carolyn@pathroot.com
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